Abstract: Abstract： Objectives To observe the clinical effects of intentional replantation on treatment of refractory periapical periodontitis of a mandibular molar. Methods A lower second molar with refractory periapical periodontitis was extracted. The tooth apical and the socket were curetted, immediately followed by replantation of the tooth and fixation. Results Two weeks after the surgery, the soft tissues showed minimal inflammation and the fistulous tract was resolved. Four weeks later, the tooth remained clinically asymptomatic and after three months the tooth was almost stable. Six months later, the tooth clinical examination was normal and new bone was observed in the alveolar socket. Conclusion Intentional replantation is an effective treatment option for those teeth with refractory periapical periodontitis when periradicular surgery or dental implant is not feasible.

Key words: intentional replantation, refractory periapical periodontitis, periapical biofilm